Calcaneocuboid fusion in children undergoing talectomy

The aim of management of the child with a severe, rigid equinovarus foot is to provide a foot that is plantigrade and painless and can be placed within standard footwear. The authors identified a retrospective cohort of 17 children with a mean age at surgery of 5.6 years (range 2.3-9.6 years) who underwent 31 talectomy procedures for the management of their rigid, equinovarus foot deformities (14 isolated talectomies, 17 combined talectomy and calcaneocuboid fusions). The underlying diagnosis was predominantly arthrogryposis. The average follow-up was 9.7 years (range 2.3-9.5 years) and 3.8 years (range 2.8-9.6 years) respectively. The addition of calcaneocuboid fusion prevented the development of postoperative equinus, varus, adductus, and supination deformities as determined by clinical examination at medium-term follow-up (P = 0.01, P < 0.001, P < 0.001, P < 0.001, P < 0.01, respectively). This was associated with a decreased incidence of recurrent foot pain with weightbearing (P < 0.001) and a reduced need for revision surgery for pain or deformity (P < 0.001). This study determined that the addition of a concomitant calcaneocuboid fusion in the setting of talectomy may improve the medium-term surgical outcome.